American journal of public health最新文献

Objectives. To examine whether, through interactions with preexisting socioeconomic status vulnerabilities, the COVID-19 pandemic exacerbated exposure to firearm violence among communities with a legacy of redlining (i.e., grading the creditworthiness of neighborhoods based on their sociodemographic composition). Methods. We used an exogenous population threshold whereby the Home Owners Loan Corporation graded neighborhoods only in US cities with populations of more than 40 000 and used a difference-in-difference strategy to examine the evolution of fatal firearm incidents between 2017 and October 2022. Results. After the COVID-19 pandemic began, fatal firearm violence increased significantly in low-graded neighborhoods that the Home Owners Loan Corporation had deemed risky for mortgage lending. The effect held consistently across various model specifications. Conclusions. Social and environmental constructs can interact in a complex manner to compound disadvantage and exacerbate the consequences of negative shocks for marginalized communities. Public Health Implications. Home Owners Loan Corporation policies contributed to widening racial disparities in firearm violence, highlighting the need for reinvestment in marginalized communities to keep future shocks from exacerbating vulnerability to adverse outcomes. (Am J Public Health. 2025;115(2):161-169. https://doi.org/10.2105/AJPH.2024.307891).

Objectives. To provide a legal epidemiology review of state-level policies that regulate the direct delivery of recreational and medical cannabis in the United States. Methods. We conducted a comprehensive review to identify all relevant policies as of July 1, 2024. Specifically, we developed a coding scheme to capture laws governing (1) direct delivery of recreational cannabis, (2) licensing for direct delivery of recreational cannabis, (3) direct delivery of medical cannabis to qualifying patients, and (4) medical cannabis delivery solely from caregivers to qualified patients. Results. Fourteen states authorized the direct delivery of recreational cannabis to adults. Twenty-six states and the District of Columbia permitted the direct delivery of medical cannabis to qualifying patients. Twelve states allowed the delivery of medical cannabis to patients exclusively through caregivers. There were numerous variations in the licensing and authorization of recreational and medical cannabis delivery. Conclusions. States varied in how the delivery of cannabis was regulated. Public Health Implications. A comprehensive review of state-level policies on cannabis delivery highlights the diverse approaches and their implications for recreational and medical cannabis access. (Am J Public Health. 2025;115(2):178-190. https://doi.org/10.2105/AJPH.2024.307874).

To strengthen lead poisoning prevention efforts among Afghan children, King County, Washington's Hazardous Waste Management Program partnered with Afghan Health Initiative, a community-based organization. The partnership arranged culturally tailored home visits and follow-ups, in which a health environment investigator and a community health advocate identified lead exposure risks and offered parents guidance. The involvement of an Afghan-led organization significantly increased community responsiveness and case management opportunities, demonstrating how public health‒community collaborations can address health challenges disproportionately affecting refugees and immigrants. (Am J Public Health. 2025;115(2):142-145. https://doi.org/10.2105/AJPH.2024.307905).

Without perspectives of low-wage workers in studies of worker health and well-being, researchers cannot comprehensively assess occupational health and health equity impacts of workplace exposures and interventions. Researchers and practitioners have noted particular challenges in engaging low-wage workers in worksite-based health survey research, yet little scholarship has described strategies for improving their engagement and response rates. To fill this gap, we present case examples from 5 occupational studies conducted between 2020 and 2024 in industries including health care, food service, and fulfillment centers. For each case, we describe how we identified barriers to worker engagement in surveys, explain specific strategies we used to address those barriers, and assess the effectiveness of these actions. Then, summarizing across case examples, we offer practical recommendations to researchers surveying low-wage populations, highlighting that high-touch recruitment, building trust with workers and managers, and obtaining manager support to take surveys during work time (for worksite-based studies) are critical for obtaining reliable, representative data. Our work contributes to broader discussions on improving survey response rates in vulnerable worker populations and aims to support future researchers undertaking similar efforts. (Am J Public Health. 2025;115(2):201-208. https://doi.org/10.2105/AJPH.2024.307875).

Objectives. To assess the impact of state COVID-19 vaccine mandates for health care workers (HCWs) on health sector employment in the United States. Methods. Using monthly state-level employment data from the Quarterly Census of Employment and Wages between January and October 2021, we employed a partially pooled synthetic control method that accounted for staggered mandate adoption and heterogeneous treatment effects. We conducted analyses separately for the 4 health care subsectors-ambulatory health care services, hospitals, nursing and residential care, and social assistance-with an additional analysis of 2 industry groups-skilled nursing care and community care for the elderly-under the nursing and residential care subsector. We further explored possible heterogeneous impacts according to the test-out option availability. Results. Mandate impact estimates were statistically indistinguishable from zero. Results further ruled out a mandate-associated decrease in employment larger than 2.1% of premandate employment levels for the 6 health care domains examined and for states with no test-out option. Conclusions. State COVID-19 vaccine mandates for HCWs were not found to be associated with significant adverse impacts on health sector employment even in states without a testing alternative to vaccination. The findings support vaccine mandates as a viable preventive measure without material disruption to the health care workforce, including in times of public health emergencies. (Am J Public Health. Published online ahead of print January 23, 2025:e1-e5. https://doi.org/10.2105/AJPH.2024.307906).

We examined the impacts of interior border checkpoints on access to higher-level medical care via ground ambulance for undocumented immigrants in South Texas. Using purposive sampling, we conducted interviews (n = 30) with ground ambulance personnel in the lower Rio Grande Valley, Texas. Procedures implemented in 2018 mandate that hospitals notify Border Patrol of a patient's legal status before transfer. Undocumented immigrants cannot access higher-level medical care through ground ambulance transport without notifying Border Patrol. (Am J Public Health. Published online ahead of print January 23, 2025:e1-e4. https://doi.org/10.2105/AJPH.2024.307927).